This is a randomized, placebo-controlled trial of nandralone decanoate in dialysis patients. Patients from SFGH dialysis unit with laboratory evidence of malnutrition or with physical limitations related to their disease (by questionnaire) will be randomized to receive 100 mg IM nandralone every week versus placebo for 6 months. Baseline evaluation of biochemical parameters, exercise tolerance, body composition, and quality of life will be followed by 3 month re-evaluation. Body composition and exercise tolerance will be evaluated at the GCRC.